Women’s cognition more affected by surgery, general anesthesia

Among older adults who underwent surgery and were exposed to general anesthesia, women had significantly faster rates of deterioration of cognition, functional status and brain volume, compared with men, according to recently published data presented at the Alzheimer’s Association International Conference.

“This is one of the first studies to suggest that among older adults, women are at a higher risk for postoperative brain dysfunction than men. Our research clearly shows an association between surgery, general anesthesia and cognitive decline in older adults,” study researcher Katie Schenning, MD, MPH, Oregon Health & Science University in Portland, said in a press release.

To assess the impact of anesthesia and surgery on cognition, function and brain volume in older adults, Schenning and colleagues analyzed data from the Intelligent Systems for Assessing Aging Changes and the Oregon Brain Aging Study.

Overall, 182 patients out of the 527 participants underwent 331 procedures where general anesthesia was used.

Compared with exposed men, women who were exposed to general anesthesia or surgery had faster rates of deterioration in the Mini-Mental State Examination (MMSE; P < .001), Clinical Dementia Rating (CDR; P = .003), CDR-Sum of Boxes (CDR-SB; P < .001), Activities of Daily Living (ADL; P < .001), Delayed Logical Memory (P = .011) and ventricular volume (P = .005).

Men were found to have faster rates of decline in the MMSE (P = .009), Instrumental ADL (P = .024) and CDR-SB (P .027), compared with men who were not exposed to surgery or general anesthesia.

“More studies are needed to confirm this observation and to identify ways to minimize the effects of surgery and general anesthesia on older adults. Future research should focus on whether certain people are more susceptible to postoperative cognitive decline by virtue of sex or genetic risk factors,” Schenning said in the release. – by Casey Hower